HESI 2023/2024 7th edition PEDS part 1

When caring for a child with congenital heart disease and polycythemia, which nursing action has the highest priority? - correct answer Maintaining adequate hydration The nurse is preparing a teaching plan for the mother of a child who has been diagnosed with celiac disease. Choosing which lunch will be within the therapeutic management of a child with celiac disease? - correct answer Baked chicken, coleslaw, soda, and frozen fruit dessert A 7-month-old male infant diagnosed with spastic cerebral palsy is seen by the nurse in the clinic. Which statement by the parent warrants immediate intervention by the nurse? - correct answer "My son often chokes while I am feeding him." The nurse is caring for a child with intussusception who is scheduled for a barium enema prior to a surgical procedure. Which action should the nurse take first? - correct answer Place the child on a clear liquid diet. The nurse should teach the parents of a child with a cyanotic heart defect to perform which action when a hyper cyanotic spell occurs? - correct answer Allow the child to assume a knee-chest position, with the head and chest slightly elevated. The nurse is teaching the parents of a 2-year-old child with a congenital heart defect about signs and symptoms of congestive heart failure. Which information about the child is most important for the parents to report to the healthcare provider? - correct answer Exhibits a sudden and unexplained weight gain. Prophylactic antibiotics are prescribed for a child who has mitral valve damage. The nurse should advise the parents to give the antibiotics prior to which occurrence? - correct answer Urinary catheterization A 7-month-old infant with a rotavirus causing severe diarrhea is admitted for treatment. Which action should the nurse take first? - correct answer Insert an intravenous (IV) line and begin IV fluids. The nurse admits a child to the intensive care unit with a possible diagnosis of Wilms tumor. What is the most important safety precaution for child? - correct answer Place a do not palpate abdomen sign on head of bed. The nurse is taking the family history of a 2-year-old child with atopic dermatitis (eczema). Which statement by the mother is most important in formulating a plan of care for this child? - correct answer "My husband and our daughter are both lactose-intolerant." A mother calls the clinic because her 6-year-old son, who has been taking prescribed antibiotics for 7 of the previous 10 days, continues to have a cough that she reports is worsening. Further questioning by the nurse reveals that the cough is nonproductive. What is the nurse's best instruction to the mother? - correct answer Bring the child to the clinic today for an examination related to the cough. The nurse is assessing a male adolescent client's knowledge of contraception. The teen states, "I have all the info I need." What is the best response by the nurse? - correct answer "Tell me what you know about birth control." The nurse is examining a male child experiencing an exacerbation of juvenile rheumatoid arthritis (JRA) and notes that mobility is greatly reduced. What is the most likely cause of the child's impaired mobility? - correct answer Joint inflammation A father of a 5-year-old calls the nurse to report that his child, who has had an upper respiratory infection, is complaining of a headache, with a rectal temperature of 103°F/39.4°C. Which action has the highest priority? - correct answer Tell the parent to take the child to the emergency department. A child comes to the school nurse complaining of itching. Further assessment reveals that the child has impetigo. What action should the nurse take? - correct answer Send the child home with the parents to see the healthcare provider before returning to school. An infant is receiving digoxin for congestive heart failure. The apical heart rate is assessed at 80 beats/min. What action should the nurse take first? - correct answer Obtain a therapeutic drug level. The nurse is conducting an initial admission assessment of a 12-month-old child in celiac crisis. Which action is most important for the nurse to take first? - correct answer Assess the child's mucous membranes and skin turgor. When inserting a nasogastric tube into the stomach of a 3-month-old infant, which action is most important for the nurse to take first? - correct answer Monitor the infant's heart rate. The nurse assigns an unlicensed assistive personnel (UAP) to provide morning care to a newly admitted child with bacterial meningitis. What is the most important instruction for the nurse to review with the UAP? - correct answer Use designated isolation precautions. The nurse is helping a family prepare to send their 7-year-old child to school for the first time. The child is wheel-chair bound, and has a permanent tracheostomy. What information must the nurse include in the teaching plan for the child? - correct answer Place suctioning supplies on the back of the wheelchair when transporting. A woman is being discharged following the birth of her second child. Her first child died at 6 weeks of age because of sudden infant death syndrome (SIDS). The mother tells the nurse that she is fearful that this infant will also develop SIDS. What is the nurse's best response? - correct answer "The fear of losing another child to SIDS is very realistic. Have you thought about what support you may need?" A 3-week-old infant is referred to an orthopedic clinic because the pediatrician heard a click when flexing the child's right hip during a routine physical examination. Which risk factor is most closely related to developmental hip dysplasia? - correct answer Breech presentation The nurse is teaching an adolescent girl with scoliosis about a Milwaukee brace that her healthcare provider has prescribed. Which instruction should the nurse provide to this client? - correct answer Remove the brace 1 hour each day for bathing only. Which preoperative nursing action should be included in the plan of care for an infant with pyloric stenosis? - correct answer Observe for projectile vomiting. The nurse expects a 2-year-old child to exhibit which behavior? - correct answer Display possessiveness with toys. The nurse is preparing a health teaching program for parents of toddlers and preschoolers, and plans to include information about the prevention of accidental poisonings. It is most important for the nurse to include which instruction? - correct answer Store all toxic agents and medicines in locked cabinets. The nurse observes a 4-year-old boy in a day care setting. Which behavior should the nurse expect this child to exhibit? - correct answer Boasts aggressively when telling a story. A 3-month-old infant weighing 10 lb 15 oz has an axillary temperature of 99.6°F. How many calories per day will the nurse include in the infant's plan of care? - correct answer600 calories/day The nurse is planning postoperative care for a child who has had a cleft lip repair. What is the most important reason to minimize this child's crying during the recovery period? - correct answer Crying stresses the suture line. A 6-month-old infant is admitted to the post-anesthesia care unit with elbow restraints in place. An endotracheal tube is in place connected to a ventilator, but the child will be extubated soon following recovery from anesthesia. Which action should the nurse include in the child's postoperative care? - correct answer Remove restraints one at a time and provide range-of-motion exercises. A nurse is preparing to end the shift and receives a laboratory report stating that a child with asthma has a theophylline level of 15 mcg/dL. Which action should the nurse take? - correct answer Communicate the result to the oncoming nurse and document. Following the administration of immunizations to a 6-month-old infant, the nurse provides the family with home care instructions. Which statement by the mother indicates that further teaching is needed? - correct answer "I will give my baby a baby aspirin every 4 hours as needed for fever." During routine screening at a school clinic, an otoscope examination of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. Based on these findings, what action should the nurse take? - correct answer Ask if the child has had a cold, runny nose, or any ear pain lately. A 2-year-old child with trisomy 21 (Down syndrome) is brought to the clinic for a routine evaluation. Which assessment finding suggests the presence of a common complication often experienced by those with Down syndrome? - correct answer Presence of a systolic murmur At which point during the physical examination should a child with asthma be assessed for the presence or absence of intercostal retractions? - correct answer Inspiration A newborn whose mother is HIV-positive is scheduled for the first follow-up assessment with the nurse. If the child is HIV-positive, which initial symptom will the child most likely exhibit? - correct answer Persistent cold An 18-month-old child returns to the unit following a cardiac catheterization with a cannulated femoral artery site. Which action will the nurse include when teaching the parents about immediate post-procedure care? - correct answer Show the parents how to hold the child with the extremity extended. The nurse notes that a 16-year-old is refusing classmates visits. Further assessment reveals a concern over edematous facial features. Which concern will the nurse plan to address first? - correct answer Ineffective coping A child breaks out with varicella infection while hospitalized for a minor surgical procedure. Which action should the nurse take first? - correct answer Place the child in strict isolation to prevent an outbreak on the unit. A 4-year-old child has cystic fibrosis. Which stage of Erikson theory of psychosocial development is the nurse addressing when teaching inhalation therapy? - correct answer Initiative In making the initial assessment of a 2-hour-old infant, which finding should lead the nurse to suspect a congenital heart defect? - correct answer Diminished femoral pulses A 3-month-old infant returns from surgery with elbow restraints and a Logan bow over a cleft lip suture line. Which action should the nurse take to maintain suture line integrity during the initial postoperative period? - correct answer Place the infant upright in an infant seat position. Following the reduction of an incarcerated inguinal hernia, a 4-month-old boy is scheduled for surgical repair of the inguinal hernia. Under which circumstance should the parents notify the healthcare provider prior to surgery? - correct answer Presence of an inguinal bulge after gentle palpation Which vital sign is most important to assess in the 6-year-old child brought to the clinic with reddened, open, and oozing skin lesions? - correct answer Temperature The mother of a 1-year-old states to the nurse, "Look at those red raised areas all over my baby! What could they be?" What is the next nursing action? - correct answer Ask, "Has the baby been around anyone with scabies?" The nurse is providing care for a child newly admitted in a sickle cell crisis. In reviewing the admission prescriptions, which prescription is concerning and the nurse needs to confirm with the healthcare provider? - correct answer Meperidine 15 mg IV every 4 hours, around the clock for pain. A child is recovering from a splenectomy secondary to a diagnosis of β-Thalassemia major. What is the most important instruction the nurse must include in the child's discharge plan? - correct answer Report signs of infection. The nurse in the emergency department has recently admitted four children. Which child will the nurse bring to the attention of the healthcare provider first? - correct answer A 2-year-old with vomiting and diarrhea for 48 hours The nurse is planning care for a newborn. What is the best time to draw the newborn's phenylketonuria (PKU)? - correct answer Around 48 hours after birth A child admitted to the emergency department is lethargic and has a fruity aroma to the breath, blurred vision, and a headache. What question will the nurse ask the parents first? - correct answer" Has your child ever been treated for diabetes before this?" For the child admitted to the emergency department with an elevated blood glucose level, the nurse will anticipate an order for which kind of insulin? - correct answer Regular Which nursing action will the nurse take first for the child known to have diabetes admitted to the emergency room? - correct answer Take a blood glucose reading. The nurse assesses a newborn during an initial feeding of formula and notes choking, coughing, and bluish lips. What is the nurse's next action? - correct answer Stop the feeding. A mother of a 4-year-old calls the clinic and reports that her child has non regular, hard and dry stools. She reports a diet high in whole milk, processed meats, bananas, and macaroni and cheese. She states, "That's all I can get my child to eat right now." What is the nurse's best reply? - correct answer" Try replacing the macaroni with a whole wheat macaroni." A mother is carrying in her 3-year-old to the emergency department (ED) screaming, "I think my baby swallowed a bottle of Tylenol." What is the nurse's next action? - correct answer Take the child's vital signs. A mother calls into the clinic and reports her 4-year-old, who spends 50 hours in day care a week, is constantly scratching the perianal area. The child is also sleeping poorly and has started wetting the bed at night. What is the nurse's next action? - correct answer Instruct the mother on how to perform the tape test. A newborn is suspected of having an imperforate anus. What is most important for the nurse to include in the child's plan of care? - correct answer No rectal temperatures. The clinic nurse is reviewing the newly received lab reports. The report from an 8-year-old indicates chlamydial conjunctivitis. What is the nurse's next action? - correct answer Alert the proper authorities of possible sexual abuse. The nurse is preparing to administer eardrops to a 2-year-old. What is the proper procedure for administering this medication? - correct answer Pull the pinna down and back. A 9-year-old child is recovering from a tonsillectomy. The nurse notes that the child is swallowing frequently. What is the nurse's next action? - correct answer Place in a side-lying position. A nurse in the emergency department is working with a nursing student. Which student action will the nurse need to correct when caring for a child with epiglottitis? - correct answer Take an oral temperature. After a 3-day hospitalization for croup, secondary to mycoplasma pneumonia, the nurse is working with the parents to discharge the child home. The parents state to the nurse, "we do not have the money to purchase the right kind of vaporizer." What is the nurse's best action? - correct answer Ask, "Do you have a freezer with your refrigerator?" The charge nurse is planning the placement of a child for admission from the emergency department with respiratory compromise of unknown origin. What is the best bed placement for this child's admission? - correct answer Single room close to the nurse's station, and away from any other children with respiratory issues A 2-year-old child is placed in an oxygen tent. What clothes will the nurse recommend the parents bring from home for the child? - correct answer An all-cotton sleeper A child presents again to the school nurse with dyspnea, wheezing, diaphoresis, and deep dark-red lips. What is the next nursing action? - correct answer Ask, "Do you have your inhaler?" The nurse is reviewing the laboratory results for a child admitted to rule out cystic fibrosis. Which test result should the nurse bring to the immediate attention of the healthcare provider? - correct answer Sweat chloride concentration of 80 mEq/L The nurse is planning care for the four clients assigned. Which nursing action takes priority? - correct answer Chest physiotherapy upon awakening for the child with cystic fibrosis How will the nurse plan to position a child with left sided pneumonia? - correct answer On the child's left side The nurse is providing care for an infant started on digoxin. The am assessment of this child included poor feeding and vomiting, and a heart rate of 96 beats/min. The am digoxin level is 2.3 ng/mL. What is the nurse's next action? - correct answer Notify the healthcare provider. The nurse is reviewing laboratory values of a child just started on furosemide. The child's serum potassium level is 4.2 mEq/L. What is the nurse's next action? - correct answer Document the finding in the nurse's notes.